The association between dominant food patterns and the intake of energy and macronutrients with endometriosis in women aged 15–45

BACKGROUND: Endometriosis is a chronic, inflammatory condition affecting women, characterized by the presence of endometrial tissue outside the uterus. This study aimed to explore the relationship between dominant food patterns and the incidence of endometriosis in women aged 15-45 years. METHODS: This case-control study involved 180 women, with 60 participants in the case group (with endometriosis) and 120 in the control group. Participants, aged 15-45, were recruited from the Kosar Educational and Therapeutic Center. Endometriosis diagnosis was confirmed via ultrasound or laparoscopy by a gynecologist. Dietary intake was assessed using a 146-item food frequency questionnaire. Factor analysis was used to identify dominant dietary patterns, and statistical tests (Chi-squared, Mann-Whitney U, T-tests) alongside logistic regression were used to assess the relationship between dietary patterns and endometriosis, adjusting for confounding factors (e.g., BMI, menstrual cycle characteristics, physical activity, education level). RESULTS: Three dominant dietary patterns were identified. Pattern one was high in red meat, solid oils, high-fat snacks, and processed foods. Pattern two featured vegetables, grains, and coffee, while pattern three included sugar, cereals, and jam. Significant associations were found between food pattern one (OR = 25.54, 95% CI: 111.72-5.84, P < 0.001) and food pattern three (OR = 1.86, 95% CI: 1.14-3.04, P = 0.01) with increased risk of endometriosis. Higher energy, lipid, and carbohydrate intake were significantly associated with endometriosis (P < 0.001). CONCLUSIONS: Food patterns high in processed meats, oils, and sugars may increase the risk of endometriosis in women. TRIAL REGISTRATION: The study was conducted according to the guidelines of the Declaration of Helsinki and approved by the Ethics Committee of Urmia University of Medical Sciences, Urmia, Iran (Ethics Code IR.UMSU.REC.1400.396).